SECTION 3.8016. Continued Stay Criteria for Partial Hospitalization Services

(a) Eligibility for continued stay in a residential rehabilitation/treatment program shall be based on the patient's meeting at least one of the conditions in paragraph (1) or (2) of this subsection.

(1) Chemical dependency rehabilitation/treatment complication. The patient must meet the conditions in subparagraph (A) or (B) of this paragraph.

(A) Patient recognizes or identifies with the severity of the alcohol and/or drug problem, but demonstrates minimal insight into the patient's defeating use of alcohol/drugs, but documentation in the record indicates that the patient is progressing in treatment.

(B) Patient identifies with the severity of the patient's alcohol and/or drug problem and manifests insight into the patient's personal relationship with mood-altering chemicals, yet does not demonstrate behaviors that indicate that the patient is developing problem solving skills necessary to cope with the problem.

(2) Psychiatric or medical complications. The patient must meet the conditions in subparagraph (A) or (B) of this paragraph.

(A) Documentation in the record indicates an intervening medical or psychiatric event which was serious enough to interrupt rehabilitation/treatment, but the patient is again progressing in treatment.

(B) Documentation in the record indicates that the patient is being held pending an immediate transfer to a psychiatric, acute medical service, or inpatient detoxification alcohol/drug service.

(b) In determining utilization review points discussed in §3.8018 of this title (relating to Recommended Length of Stay for Partial Hospitalization Services), the criteria in subsection (a)(1) and (2) of this section shall be considered.

Source Note: The provisions of this §3.8016 adopted to be effective August 28, 1991, 16 TexReg 4403